This invention relates to a device or apparatus for use in performing end-to-end anastomoses. This invention also relates to an associated method for performing end-to-end anastomoses.
Where the colon is ressected, for example, owing to trauma or in corrective cancer surgery, the loose ends must be connected to one another to form a continuous, functioning colon. This connection or reconnection is commonly performed with a stapling instrument comprising a stapling member inserted through the rectum and into a first closed colon segment. An anvil member is inserted through the open end of another colon segment. That open end is then closed via a purse-string tie about a shaft projecting from the anvil member. The shaft is subsequently attached in telescoping fashion to a rod projection through the first colon segment from the stapling member.
Upon a connection of the stapling memebr and the anvil member, the two section are drawn towards one another via a screw mechanism operated from the proximal end of the stapling member, i.e., from outside the rectum. The closed ends of the colon segments are thus clamped between the stapling member and the anvil member of the anastomosis device. Upon completion of the clamping operation, the staples are ejected in two staggered circular arrays in a distal, axial direction from the stapling member towards the anvil member. Simultaneously, or immediately after the stapling operation, a circular blade is pushed in the distal direction from the stapling member axially towards the anvil member, thereby opening the colon segments to communication with one another.
After the stapling and cutting operation, the entire instrument is removed out through the rectum. Frequently, there is some difficulty in removing the instrument owing to the fact that the diameter of the colon segments at the anastomosis joint is smaller than the diameter of the instrument, particularly the anvil which must be pulled through the anastomosis joint.